My 5 year old daughter was diagnosed with Type 1 diabetes about three months ago, but antibodies to islet cells and insulin are negative. Is this relevant to the course of the diabetes or to prognosis for other autoinmune diseases or complications?

Answer:

I think that your daughter may have what in the U.S. would be called Type 1B Diabetes, a condition that is not autoimmune and is distinct from Type 1A Diabetes. Type 1B is rather uncommon in Caucasian families; but comprises a little over 50% of new onsets in the Hispanic population (I have seen no figures for European Spanish children but I believe if you contacted Dr Marco Songini in Sardinia at songinm@Box1.tin.it that he could help you). The antibody tests are of course negative and happily many can manage without insulin after a few weeks, although they continue to need oral medication and to observe the disciplines in diet and excercise required for good control of blood sugar levels.

It is not yet known what the actual mechanism for the diabetes is though some of them are known to be due to a chromosomal abnormality. Its too early to be able to report on the long term prognosis; but one would suppose that glucose ccontrol will be easier and therefore that the incidence of long term complications will be correspondingly reduced. There are some other rather rare possibilities which I have discounted on the assumption that your daughter is on insulin.

Last Updated: Tuesday April 06, 2010 15:09:02
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